PRE MCQ PAPER Flashcards by Emma Wilson

Give examples of beta lactamase-resistant penicillns. (HINT: there’s 5)

methicillin
oxacillin
cloxacillin
dicloxacillin
nafcillin

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Name the 2 broad spectrum penicillins.

Ampicillin

Amoxicillin

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Name the 4 extended-spectrum penicillins.

carbenicillin
ticaracillin
azlocillin
piperacillin

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What are carbapenamases resistant to? What is their MoA?

Resistant to typical beta lactamases

They bind to beta lactamase, acylating the enzyme - rendering it inactive

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What are the 2 beta lactamase inhibitors? When/what are they used for?

CLAVULANIC ACID and SALBACTAM

inhibit class A beta lactamase
can be administered alongside a beta lactam antibiotic instead of using a beta lactamase resistant antibiotic

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What are the 6 uses of cephapholsporins? What are the 4 examples?

Against septicaemia, pneumonia, meningitis, biliary tract infections, UTIs, sinusitis
Examples = cefalexin, cefuroxime, cefotaxime, cefadroxil

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What is bacitracin used to treat?

As an ointment to treat infections of the skin and eye by streptococci and staphylococci

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What are the therapeutic uses of sulphonamides and trimethoprim?

Trimethoprim - UTIs
Co-trimoxazole - toxoplasmosis
With other drugs for opportunistic infections in AIDS pts

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What are 2 macrolides? When are they usually used?

Erythromycin and Clarithromycin

penicillin alternative
used for community acquired LRTIs

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What is the spectrum of activity of aminoglycosides?

septicaemia
serious UTIs
Hospital acquired pneumonia
Resp and intra abdominal infections

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What are tetracyclines used to treat?

First choice for rickettsial, mycoplasma and chalmydial infections, brucellosis, cholera, plague and lyme disease
Can be used in COPD or treating chronic acne.

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What is the most commonly used fluoroquinolone currently?

Ciprofloxacin

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For the following quinolones, state their uses (i) naladixic acid (ii) norfloxacin, cirpofloxacin (iii) motifloxacin, gatifloxacin, gemifloxacin

(i) UTI
(ii) systemic infection
(iii) acute lower RTI

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For lung cancer, what drug is used (i) If EGFR mutations present (ii) KRAS mutations present (iii) ALK rearrangement = 4% fusion?

(i) erlotinib
(ii) no drug
(iii) crizotinib

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For colorectal cancer what is the personalised treatment?

If there are no KRAS/NRAS mutations then cetuximab plus chemotherapy

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For lung cancer, what drug is used if (i) BRAF mutations present (ii) KIT mutations present?

(i) vermurafenib

(ii) imatinib

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What drug is used in brain tumours (high grade glioblastomas) when there is a high percentage of MGMT promoter methylation?

Temozolomide

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For gastric tumours, what drug is used if GIST has KIT mutations present?

Imatinib

What 2 drugs are used in relation to anti-PD-1/PD-L1? Describe what they do

Nivolumab - anti PD-1 antibody used in melanoma and squamous NSCLC
Ipilimumab - anti-CTLA-4 antibody used in metastatic melanoma

What are the names of the 4 tri-azole drugs?

fluconazole
itraconazole
posaconazole
voriconazole

What is fluconazole used to treat?

Fungal meningitis

Candiduria

What is itraconazole used to treat?

Treats a wide range of dermatophytes

What is (i) posaconazole (ii) voriconazole used to treat?

(i) invasive fungal infections unresponsive to treatment

(ii) used in life-threatening infections

What is flucytosine used to treat?

Systemic yeast and fungal infections

As an adjunct to amphotericin in cryptococcal or systemic condidiasis

What are the 2 polyenes?

Amphotericin and Nystatin

What is the clinical uses of (i) amphotericin (ii) nystatin?

(i) IV for systemic fungal infections as active against most fungi and yeasts - usually given in lipid formulation as it is significantly less toxic (ii) oral, oropharyngeal and perioral infections

What are the 3 echinocandins? What are their clinical uses?

Adidulafungin, Capsofungin, Micafungin - only capsofungin against aspergillus species - all 3 against candida species

When is terbinafine used clincially?

dermatophyte infections of the nails | ringworm infections where oral therapy is appropriate

When is griseofulvin used clinically?

Dermatophyte infections of the skin, scalp, hair and nails where topical therapy has failed/inappropriate

What is the treatment of invasive candidiasis?

Echinocandin can be used - FLUCONAZOLE in candida albicans who haven't received an 'azole' recently - AMPHOTERICIN when the above cannot be used - VORICONAZOLE pts intoletant of above or those with fluconazole resistant candida

What is the treatment for superficial candidiasis?

Treated locally with miconazole Widespread/intractable requires fluconazole itraconazole for infectinons unresponsive to fluconazole

What is the treatment for aspergillosis?

Voriconazole = treatment of choice Liposomal amphotericin when above cant be used Then capsofungin, itraconazole or posaconazole for those intolerant of the above

What is the treatment for cryptococcal meningitis?

Amphotericin and Flucytosine by IV for 2 weeks | followed by oral fluconazole for 8 weeks/till cultures negative

What are the uses of aciclovir?

HSV and VZV - genital herpes, herpes simplex labialis - shingles, chickenpox in immunocompromised pts ETC. (other herpes)

What is used to treat cytomegalovirus?

Ganciclovir and valganciclovir

What are the 2 RNA viruses?

Influenza | Hep C virus

What are the 2 types of retroviruses?

HIV | Human T cell Leukaemia Virus

What are the 5 types of drugs used to treat retroviruses? Give an example for each.

1, RT inhibs - NRTI = abacavir - NNRTI = delaviridine 2. PR inhibs - atanzavir 3. Entry inhib - maraviroc 4. Fusion inhib - Enfuvitide 5. IN inhib - raltegravir

What is the MoA of (i) NRTI (ii) NNRTI?

(i) inhibit viral DNA synthesis by acting as a chain terminator (ii) Binding induces conformational changes which inhibit the catalytic activity of RT

What is the use of (i) raltegravir (ii) dolutegravir (iii) elvitegravir?

(i) pts with HIV resistant to other HAART regimens (ii) Add on to concurrent HAART therapy (iii) used for pts starting HIv treatment for 1st time

What is HAART?

Highly active anti-retroviral therapy - combo of 3 or 4 different drugs - usually 2 NRTIs with a NNRTI, PI or most recently an IN inhibitor

What is used to treat influenza?

Amantadine Rimantidine Oseltamivir - oral Zanamivir - nasal spray

What drugs are used for the treatment of Hep C?

ribavirin peginterferon alpha simeprevir, ledipasvir and sofosbuvir protease inhibitors (telaprivir, boceprivir, paritaprevir)